35 ILCS 200/21-275
The application for certificate of purchase shall be executed by the purchaser and by any individual bidder acting in the purchaser's behalf. The application shall be initially executed and delivered to the county clerk at the time of registration for the sale as provided in this Section. Before receiving any certificate of purchase, each purchaser and individual bidder acting in the purchaser's behalf shall sign and deliver to the county clerk a schedule or schedules of the properties for which that purchaser has successfully bid and is applying to purchase, which schedule(s) shall be attached to and incorporated within the application. The schedule(s) shall be accompanied by a fee, for each property listed, of $10 in counties with less than 3,000,000 inhabitants and $20 in counties with 3,000,000 or more inhabitants. The application and schedule(s) shall be in substantially the following form:
APPLICATION FOR CERTIFICATE OF PURCHASE Date of Application: ............... Name of Purchaser: ................. Address: ........................... Name of Bidder: .................... Address: ........................... I (we) hereby apply to the County Clerk and County Treasurer of ..... County for issuance of a certificate of purchase for each of the properties on the attached schedule(s), and state as follows: 1. I (we) made (or authorized) the successful bid on each property listed on the attached schedule(s) at the sale of delinquent properties under Section 21-260 of the Property Tax Code conducted by the County Treasurer of ..... County, Illinois, on the dates indicated for each property on the schedule(s). 2. At least 5 business days before the first day of this sale, I (we) submitted a truthful, accurate and complete registration to the Treasurer of ..... County on the form(s) and according to the regulations prescribed by the Treasurer's office. 3. Neither I (we) nor any person or firm identified in the registration submitted to the Treasurer of ..... County was an owner or agent of an owner, mortgagee or agent of a mortgagee, lienholder or agent of a lienholder, holder of beneficial interest or agent of a holder of a beneficial interest in or of any property identified on the schedule(s) attached to this application on January 1st of any years for which taxes were delinquent at the time of my (our) bid(s) described in the schedule(s). 4. Neither I (we) nor any person or firm identified in the registration submitted to the Treasurer of ..... County was an owner or agent of an owner, mortgagee or agent of a mortgagee, lienholder or agent of a lienholder, holder of a beneficial interest or agent of a holder of a beneficial interest in or of the property identified on the schedule(s) attached to this application at the time of the bid(s) described in the schedule. 5. Neither I (we) nor any person or firm identified in the registration submitted to the Treasurer of ..... County was an owner or agent for an owner, or party or agent for a party responsible for the payment of delinquent taxes, on any property in the county which was tax delinquent or forfeited for all or any part of each of 2 or more years when the registration was submitted. 6. Neither I (we) nor any person acting in my (our) behalf has twice failed to complete a purchase at the sale during which the properties on the attached schedule(s) were offered by failing to immediately pay a minimum bid or by failing to pay the balance of a bid for any property within one business day thereafter. I (we) hereby affirm that I (we) have read this application and that the statements made in it are personally known by me (us) to be true, accurate and complete, under penalty of perjury as provided by law. I (we) further understand that this application shall be void unless the schedule(s) of properties referred to in the application is (are) completed and delivered to the County Clerk. ........................ Dated: .............. (Signature of Purchaser) ........................ Dated: .............. (Signature of Bidder) SCHEDULE OF PROPERTIES Permanent Index Number Date of Bid (insert number) (insert date) I (we) hereby affirm that I (we) successfully bid upon the above properties at the sale conducted by the County Treasurer of ..... County on the indicated dates, and I (we) request that the County Clerk of ..... County attach this schedule to my (our) application for certificate of purchase dated ...... Signed under penalty of perjury as provided by law: ........................ Dated: .............. (Signature of Purchaser) ........................ Dated: .............. (Signature of Bidder)
35 ILCS 200/21-275